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Overview

Nasal polyps are fleshy swellings or polypoidal, benign/non-cancerous masses that develop in the lining of the nose and paranasal sinuses. They usually occur in both nostrils, though unilateral polyps rarely occur. Polyp formation in the nasal cavity is due to chronic allergic rhinitis, chronic sinusitis, and, less commonly due to underlying disease such as cystic fibrosis.

Patients with large polyps present with nasal obstruction (breathing difficulty), persistent nasal discharge (rhinorrhea), sinus infection, and loss of the sense of smell (anosmia) for a prolonged duration.

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Before the Treatment

How it is Performed

Surgical removal of nasal polyps

1)Polypectomy:

It is usually done to remove polyps that are closer to the nasal opening.

Anesthesia: Local

Procedure: Initially the local anesthetic is applied to the surgical site which helps to numb the area. To carry out the surgical process, forceps or a microdebrider is used. The polyps are removed from posterior to anterior direction. Vasoconstriction is applied topically following the polyp removal, which helps to minimize bleeding along with placement of an absorbable dressing.

2) Endoscopic Sinus Surgery:

Polyps which are large and obstructive and which are not effectively managed with medications such as steroids are removed by this endoscopic sinus surgical method. This procedure helps to improve airflow through the nasal passage as well as improves sinus drainage and sense of smell and taste.

Anesthesia: General

Length of stay in hospital: 1 day, overnight stay not required

Procedure: An optical tube with a video camera at one end (endoscope) is passed into the nostrils by the surgeon. This allows them to see inside of nose and sinuses. Once the location of nasal polyps has been identified, then specialized instruments such as micro-debrider (a tiny motorized revolving shaver) are passed through the nostrils to grasp and remove the polyps in an effective and safe manner.

Sometimes, a laser device is used instead of micro-debrider along with the endoscope. The nasal passages are irrigated with warm water solution prior to the use of laser energy, to facilitate vasoconstriction. The laser device passes laser energy at various power settings, initially at low power setting followed by higher up to a level where it successfully eliminates the polyps.

Sinus surgery cost varies from hospital to hospital and country to country.

Recovery

Post-operative care

Long-term steroidal nasal spray therapy is recommended post-surgery, to delay the recurrence of the polyps quickly.

Common problems associated with endoscopic sinus surgery include:

Crusting inside the nose

Persistent bleeding from the nose

Risk of Infection at the site of the surgery

Recurrence of the polyps

Pros

Patients who have undergone endoscopic sinus surgery will experience an improvement in their symptoms.

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FAQ

A: Nasal polyps can often come back after they have been shrunken and eliminated with the help of sprays and medications. However, chances of it coming back after surgical removal are low.

Q: Is removal of nasal polyps painful?

A: Nasal polyps are nowadays removed through endoscopic nasal surgery. It results in much less pain and discomfort after the surgery.

Q: How do nasal polyps look like upon removal?

A: Nasal polyps are quite common noncancerous growths that form inside the nose or the sinuses. These look like peeled grapes from the outside when removed.

Q: How long are you out of work for sinus surgery?

A: Some patients may return back to work within a few days after the surgery, which others may take at least one to two weeks. The recovery time after nasal polyp removal depends on the extent of the surgery and the nature of the job that the patient is supposed to return to.

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